Provider Demographics
NPI:1649502576
Name:LEMKE, KATIA (DMD)
Entity type:Individual
Prefix:DR
First Name:KATIA
Middle Name:
Last Name:LEMKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 PITTS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1348
Mailing Address - Country:US
Mailing Address - Phone:407-922-8256
Mailing Address - Fax:
Practice Address - Street 1:6514 HIGHWAY 90A, SUITE 201
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498
Practice Address - Country:US
Practice Address - Phone:281-277-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN176921223X0400X
TX253021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211177504Medicaid